AHA Pediatric Advanced Life Support
Exam / Complete PALS Exam 2024-
2025 All Questions With Verified
Answers With Rationale
MULTIPLE CHOICE
1. You Are The Team Leader During A Pediatric Resuscitation Attempt. Which
Action Is An Element Of High-Quality CPR?
A) Allowing Complete Chest Wall Recoil After Each Compression
B) Administering Compressions At A Rate Of Less Than 100/Min
C) Giving Infrequent Ventilations
D) Performing Compressions Only During The First Minute
E) Limiting Chest Compression Depth To 1 Inch
ANSWER: A)
An Essential Component Of High-Quality CPR Is Allowing Complete Chest Wall
Recoil After Each Compression. This Ensures That The Heart Can Fully Fill Between
Compressions, Optimizing Blood Flow. Other Key Elements Of High-Quality CPR
Include Compressing At A Rate Of 100-120/Min, Compressing To A Depth Of At
Least One-Third The Depth Of The Chest, And Minimizing Interruptions In
Compressions.
2. A 6-Year-Old Child Is Found Unresponsive, Not Breathing, And Without A Pulse.
One Healthcare Worker Leaves To Activate The Emergency Response System And
Get The Resuscitation Equipment. You And Another Healthcare Provider
Immediately Begin CPR. Which Compression To Ventilation Ratio Do You Use?
A) 15:2
B) 30:2
,C) 5:1
D) 10:1
E) 1:1
ANSWER: A)
For Pediatric CPR With Two Rescuers, The Correct Compression-To-Ventilation
Ratio Is 15:2. This Is Based On Current Pediatric CPR Guidelines. In Single-Rescuer
CPR For A Child, The Ratio Would Be 30:2, But When Two Rescuers Are Available,
15 Compressions Are Followed By 2 Ventilations.
3. In Post-Resuscitation Management After Cardiac Arrest, Extra Care Should Be
Taken To Avoid Reperfusion Injury. What Should The Ideal Oxygen Saturation
Range Most Likely Be?
A) 85%-90%
B) 90%-94%
C) 94%-99%
D) 100%
E) 80%-85%
ANSWER: C)
After A Successful Resuscitation From Cardiac Arrest, It Is Important To Maintain
Oxygen Saturation In The Range Of 94%-99% To Optimize Oxygen Delivery To
Tissues While Avoiding Hyperoxia (Which Can Cause Reperfusion Injury). Oxygen
Saturation Higher Than 99% May Lead To Increased Oxidative Stress, While Lower
Levels Could Risk Hypoxia And Tissue Injury.
4. A 3-Year-Old Child Is In Cardiac Arrest, And High-Quality CPR Is In Progress.
You Are The Team Leader. The First Rhythm Check Reveals The Rhythm Shown
Here. Defibrillation Is Attempted With A Shock Dose Of 2 J/Kg. After
Administration Of The Shock, What Should You Say To Your Team Members?
A) "Resume Compressions"
B) "Give 2 Minutes Of CPR Before The Next Shock"
,C) "Administer Epinephrine Immediately"
D) "Check The Rhythm Again"
E) "Prepare For Intubation"
ANSWER: A)
After Delivering A Shock In Pediatric Resuscitation, It Is Critical To Resume
Compressions Immediately. Effective Chest Compressions Improve Coronary And
Cerebral Perfusion, Making It The Most Important Intervention After Defibrillation.
Pausing CPR After A Shock Is Counterproductive, As It Delays The Return Of
Spontaneous Circulation.
5. A 4-Year-Old Child In Cardiac Arrest Is Brought To The Emergency Department
By Ambulance. High-Quality CPR Is Being Performed. The Cardiac Monitor
Displays The Rhythm Strip Shown Here. The Estimated Weight Of The Child Is 20
Kg. What Dose Range Should You Use For The Initial Defibrillation?
A) 1-2 J/Kg
B) 2-4 J/Kg
C) 4-6 J/Kg
D) 1-3 J/Kg
E) 5-10 J/Kg
ANSWER: B)
For Initial Defibrillation In A Child, The Recommended Dose Is 2-4 J/Kg. This Is The
Guideline For Delivering The First Shock In Pediatric Cardiac Arrest. Subsequent
Shocks May Use Higher Doses If Required.
6. A 4-Year-Old Child In Cardiac Arrest Is Brought To The Emergency Department
By Ambulance. High-Quality CPR Is Being Performed. The Cardiac Monitor
Displays The Rhythm Strip Shown Here. The Estimated Weight Of The Child Is 20
Kg. As The Team Leader, How Many Joules Do You Tell Your Team Member To
Use To Perform Initial Defibrillation?
A) 20 Joules
, B) 40 Joules
C) 60 Joules
D) 30 Joules
E) 10 Joules
ANSWER: B)
The Appropriate Energy Dose For Defibrillation In Children Aged 1-8 Years Is 2-4
J/Kg. For A 20 Kg Child, This Would Equate To A Shock Dose Range Of 40-80
Joules. It Is Standard Practice To Start With 40 Joules For Initial Defibrillation.
7. A 4-Year-Old Child Is Brought To The Emergency Department For Seizures. The
Seizures Stopped A Few Minutes Ago, But The Child Continues To Have Slow And
Irregular Respirations. Which Condition Is Most Consistent With Your Assessment?
A) Hypoglycemia
B) Disordered Control Of Breathing
C) Postictal State
D) Respiratory Failure
E) Status Epilepticus
ANSWER: B)
After A Seizure, A Child May Have Irregular Breathing Due To Disruption Of
Normal Respiratory Control By The Brain. This Is Referred To As Disordered
Control Of Breathing And Can Present With Slow, Irregular, Or Even Absent
Breaths. The Postictal State Is A Recovery Phase After A Seizure And Can Also
Cause Altered Breathing Patterns, But The Term "Disordered Control Of Breathing"
More Directly Describes This Irregular Breathing Pattern Following A Seizure.
8. An 8-Year-Old Child Is Brought To The Emergency Department With A 2-Day
History Of Lethargy And Polyuria. The Child Has New Onset Rapid, Deep, And
Labored Breathing. Which Diagnostic Test Should You Order First?
A) Arterial Blood Gas (ABG)
B) Blood Glucose
Exam / Complete PALS Exam 2024-
2025 All Questions With Verified
Answers With Rationale
MULTIPLE CHOICE
1. You Are The Team Leader During A Pediatric Resuscitation Attempt. Which
Action Is An Element Of High-Quality CPR?
A) Allowing Complete Chest Wall Recoil After Each Compression
B) Administering Compressions At A Rate Of Less Than 100/Min
C) Giving Infrequent Ventilations
D) Performing Compressions Only During The First Minute
E) Limiting Chest Compression Depth To 1 Inch
ANSWER: A)
An Essential Component Of High-Quality CPR Is Allowing Complete Chest Wall
Recoil After Each Compression. This Ensures That The Heart Can Fully Fill Between
Compressions, Optimizing Blood Flow. Other Key Elements Of High-Quality CPR
Include Compressing At A Rate Of 100-120/Min, Compressing To A Depth Of At
Least One-Third The Depth Of The Chest, And Minimizing Interruptions In
Compressions.
2. A 6-Year-Old Child Is Found Unresponsive, Not Breathing, And Without A Pulse.
One Healthcare Worker Leaves To Activate The Emergency Response System And
Get The Resuscitation Equipment. You And Another Healthcare Provider
Immediately Begin CPR. Which Compression To Ventilation Ratio Do You Use?
A) 15:2
B) 30:2
,C) 5:1
D) 10:1
E) 1:1
ANSWER: A)
For Pediatric CPR With Two Rescuers, The Correct Compression-To-Ventilation
Ratio Is 15:2. This Is Based On Current Pediatric CPR Guidelines. In Single-Rescuer
CPR For A Child, The Ratio Would Be 30:2, But When Two Rescuers Are Available,
15 Compressions Are Followed By 2 Ventilations.
3. In Post-Resuscitation Management After Cardiac Arrest, Extra Care Should Be
Taken To Avoid Reperfusion Injury. What Should The Ideal Oxygen Saturation
Range Most Likely Be?
A) 85%-90%
B) 90%-94%
C) 94%-99%
D) 100%
E) 80%-85%
ANSWER: C)
After A Successful Resuscitation From Cardiac Arrest, It Is Important To Maintain
Oxygen Saturation In The Range Of 94%-99% To Optimize Oxygen Delivery To
Tissues While Avoiding Hyperoxia (Which Can Cause Reperfusion Injury). Oxygen
Saturation Higher Than 99% May Lead To Increased Oxidative Stress, While Lower
Levels Could Risk Hypoxia And Tissue Injury.
4. A 3-Year-Old Child Is In Cardiac Arrest, And High-Quality CPR Is In Progress.
You Are The Team Leader. The First Rhythm Check Reveals The Rhythm Shown
Here. Defibrillation Is Attempted With A Shock Dose Of 2 J/Kg. After
Administration Of The Shock, What Should You Say To Your Team Members?
A) "Resume Compressions"
B) "Give 2 Minutes Of CPR Before The Next Shock"
,C) "Administer Epinephrine Immediately"
D) "Check The Rhythm Again"
E) "Prepare For Intubation"
ANSWER: A)
After Delivering A Shock In Pediatric Resuscitation, It Is Critical To Resume
Compressions Immediately. Effective Chest Compressions Improve Coronary And
Cerebral Perfusion, Making It The Most Important Intervention After Defibrillation.
Pausing CPR After A Shock Is Counterproductive, As It Delays The Return Of
Spontaneous Circulation.
5. A 4-Year-Old Child In Cardiac Arrest Is Brought To The Emergency Department
By Ambulance. High-Quality CPR Is Being Performed. The Cardiac Monitor
Displays The Rhythm Strip Shown Here. The Estimated Weight Of The Child Is 20
Kg. What Dose Range Should You Use For The Initial Defibrillation?
A) 1-2 J/Kg
B) 2-4 J/Kg
C) 4-6 J/Kg
D) 1-3 J/Kg
E) 5-10 J/Kg
ANSWER: B)
For Initial Defibrillation In A Child, The Recommended Dose Is 2-4 J/Kg. This Is The
Guideline For Delivering The First Shock In Pediatric Cardiac Arrest. Subsequent
Shocks May Use Higher Doses If Required.
6. A 4-Year-Old Child In Cardiac Arrest Is Brought To The Emergency Department
By Ambulance. High-Quality CPR Is Being Performed. The Cardiac Monitor
Displays The Rhythm Strip Shown Here. The Estimated Weight Of The Child Is 20
Kg. As The Team Leader, How Many Joules Do You Tell Your Team Member To
Use To Perform Initial Defibrillation?
A) 20 Joules
, B) 40 Joules
C) 60 Joules
D) 30 Joules
E) 10 Joules
ANSWER: B)
The Appropriate Energy Dose For Defibrillation In Children Aged 1-8 Years Is 2-4
J/Kg. For A 20 Kg Child, This Would Equate To A Shock Dose Range Of 40-80
Joules. It Is Standard Practice To Start With 40 Joules For Initial Defibrillation.
7. A 4-Year-Old Child Is Brought To The Emergency Department For Seizures. The
Seizures Stopped A Few Minutes Ago, But The Child Continues To Have Slow And
Irregular Respirations. Which Condition Is Most Consistent With Your Assessment?
A) Hypoglycemia
B) Disordered Control Of Breathing
C) Postictal State
D) Respiratory Failure
E) Status Epilepticus
ANSWER: B)
After A Seizure, A Child May Have Irregular Breathing Due To Disruption Of
Normal Respiratory Control By The Brain. This Is Referred To As Disordered
Control Of Breathing And Can Present With Slow, Irregular, Or Even Absent
Breaths. The Postictal State Is A Recovery Phase After A Seizure And Can Also
Cause Altered Breathing Patterns, But The Term "Disordered Control Of Breathing"
More Directly Describes This Irregular Breathing Pattern Following A Seizure.
8. An 8-Year-Old Child Is Brought To The Emergency Department With A 2-Day
History Of Lethargy And Polyuria. The Child Has New Onset Rapid, Deep, And
Labored Breathing. Which Diagnostic Test Should You Order First?
A) Arterial Blood Gas (ABG)
B) Blood Glucose
